Background: For women with chronic inflammatory diseases, diagnosis and treatment initiation often overlap with peak reproductive years. High disease activity is associated with increased risk of pregnancy complications and adverse outcomes; disease control is important for patients (pts). Tumor necrosis factor antagonists (anti-TNFs) are effective, but use among Women of Childbearing Age (WoCBA) is variable. This survey aimed to help understand perceptions of healthcare professionals (HCPs) of treating WoCBA pts. Methods: The survey was conducted online in the US on 6July17 (SERMO RealTime). WoCBA: female pt aged 18–45. Participants included gastroenterologists (GI), rheumatologists (RA), dermatologists (DM), obstetricians/gynecologists (OB). Results: 256 HCPs participated (50 each GI/RA/OB, 53 DM). Half of their female pts were WoCBA. GI (31%) and RA (43%) had the highest proportion of WoCBA pts prescribed anti-TNFs (DM: 27%). Prescribing anti-TNFs decreased with family planning/pregnancy onset (Figure 1). GI (36%) and RA (46%) were less likely to recommend anti-TNF discontinuation before conception than OB (62%) and DM (57%); <35% GI/RA thought stopping treatment during pregnancy was necessary (OB: 54%; DM: 45%). Fewer GI and RA than DM and OB believed breastfeeding pts should not take anti-TNFs, although uncertainty was high (Figure 2). GI (46%) and RA (42%) strongly agreed on priority of disease control during pregnancy (DM: 15%; OB: 20%) and that controlled disease reduces pregnancy complications (GI: 52%; RA: 42%; OB: 28%; DM: 17%). HCPs believed that more safety data during and after pregnancy are needed to feel comfortable with use of anti-TNFs for WoCBA pts. Conclusion: Our survey demonstrates the variability in clinical management of women with inflammatory diseases. Uncertainty and concerns about risks of anti-TNF use during pregnancy and lactation are common; further research and multidisciplinary engagement among HCPs are needed to safely treat WoCBA.
